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Chapter 549

Provision of Drugs and Drug Information

Subchapter A. General Provisions Applicable to Provision of Drugs under Vendor Drug Program and Certain Other Programs

549.0001 Bulk Purchasing with Another State of Prescription Drugs and Other Medications 549.0002 Value-Based Arrangement in Medicaid Vendor Drug Program 549.0003 Period of Validity of Prescriptions under Medicaid 549.0004 Certain Medications for Sex Offenders Prohibited 549.0005 Prior Approval of and Pharmacy Provider Access to Certain Communications with Certain Recipients and Enrollees 549.0006 Vendor Drug Program Inclusion

Subchapter B. Review and Analysis of Certain Prescription Drug Purchases and Patterns

549.0051 Periodic Review of Vendor Drug Program Purchases 549.0052 Medicaid Prescription Drug Use and Expenditure Patterns

Subchapter C. Supplemental Rebates or Program Benefits for Prescription Drugs

549.0101 Definitions 549.0102 Requirement to Negotiate for Supplemental Rebates for Certain Programs 549.0103 Voluntary Negotiation for Manufacturer and Labeler Supplemental Rebates 549.0104 Considerations in Supplemental Rebate Negotiations 549.0105 Required Disclosures in Negotiations for Supplemental Rebates 549.0106 Program Benefits Instead of Supplemental Rebates; Monetary Contribution or Donation 549.0107 Limitations on Agreement to Accept Program Benefits Instead of Supplemental Rebates 549.0108 Treatment of Program Benefits for Certain Purposes

Subchapter D. Confidentiality of Information Relating to Prescription Drug Rebate Negotiations and Agreements

549.0151 Certain Prescription Drug Information Confidential 549.0152 General Prescription Drug Information Not Confidential; Exception 549.0153 Existence or Nonexistence of Supplemental Rebate Agreement Not Confidential

Subchapter E. Preferred Drug Lists

549.0201 Definition 549.0202 Preferred Drug Lists Required for Medicaid Vendor Drug and Child Health Plan Programs 549.0203 Preferred Drug Lists Authorized for Certain Programs 549.0204 Limitation on Drugs Included on Preferred Drug Lists; Exceptions 549.0205 Considerations for Including Drug on Preferred Drug Lists 549.0206 Submission of Evidence to Support Including Drug on Preferred Drug Lists 549.0207 Publication of Information Relating to and Distribution of Preferred Drug Lists 549.0208 Expedited Review Process for Certain Requests to Include Drug on Preferred Drug List 549.0209 Temporary Non-Preferred Status for Certain Drugs

Subchapter F. Prior Authorization for Certain Drugs

549.0251 Drugs Subject to Prior Authorization Requirements 549.0252 Prior Authorization and Certain Protocol Requirements Prohibited for Certain Antiretroviral Drugs 549.0253 Prior Authorization Prohibited for Certain Nonpreferred Antipsychotic Drugs 549.0254 Administration of Prior Authorization Requirements 549.0255 Prerequisite to Implementing Prior Authorization Requirement for Certain Drugs 549.0256 Notice of Prior Authorization Requirement Implementation and Procedures 549.0257 Prior Authorization Procedures 549.0258 Prior Authorization Automation and Point-of-Sale Requirements 549.0259 Applicability of Prior Authorization Requirements to Prior Prescriptions 549.0260 Appeal of Prior Authorization Denial under Medicaid Vendor Drug Program

Subchapter G. Drug Utilization Review Board

549.0301 Definition 549.0302 Board Composition; Application Process 549.0303 Conflicts of Interest 549.0304 Board Member Terms 549.0305 Presiding Officer 549.0306 Inapplicability of Other Law to Board 549.0307 Administrative Support for Board 549.0308 Rules for Board Operation 549.0309 General Powers and Duties of Board 549.0310 Board Meetings; Review of Certain Products 549.0311 Board Summary of Certain Information Required 549.0312 Public Disclosure of Certain Board Recommendations Required

Subchapter H. Medicaid Drug Utilization Review Program

549.0351 Definitions 549.0352 Drug Use Reviews 549.0353 Annual Report

Subchapter I. Pharmaceutical Patient Assistance Program Information

549.0401 Definition 549.0402 Provision of Program Information by Pharmaceutical Company 549.0403 Public Access to Program Information

Subchapter J. State Prescription Drug Program

549.0451 Development and Implementation of State Prescription Drug Program 549.0452 Program Eligibility 549.0453 Rules 549.0454 Generic Equivalent Authorized 549.0455 Program Funding and Funding Priorities